The curious incident of the dog in the operating theatre

Health MEC Peggy Nkonyeni’s attack on Manguzi Hospital’s Dr Mark Blaylock in the provincial legislature this week was ‘wildly exaggerated, out of context, and crudely constructed to make him and other doctors appear to be racist’.

This is according to the SA HIV Clinicians’ Society and the Rural Doctors’ Association of SA (Rudasa), which has asked the ANC’s national leadership to investigate the matter.

Blaylock’s lawyer, Mark Heywood, is also going to ask the Human Rights Commission to investigate Nkonyeni for the ‘racial tone’ of her remarks and for the harassment of Manguzi doctors.

In her Budget speech on Tuesday, Nkonyeni announced the formation of a task team to look into ‘allegations of racism, ill treatment of staff and abuse of departmental facilities by Dr Blaylock and some doctors operating at some of our rural facilities’.

The day before her speech, Nkonyeni’s staff allegedly ordered Manguzi’s hospital manager to supply her with details of every incident involving Blaylock, the doctor who threw her picture in a dustbin after she insulted rural doctors, during his six years’ service.

Despite the fact that all the incidents have already been dealt with by hospital management, Nkonyeni has announced new investigations into at least seven incidents, the most serious being that Blaylock:

assaulted radiographer Clifford Mdunge, who then needed stitches;

used an operating theatre to operate on a dog while patients were waiting;

broke a pharmacy window and attempted to assault pharmacy staff and

called striking health workers ‘baboons’.

Since making her speech, Nkonyeni has expanded the charges against Blaylock in media interviews, claiming that he was reluctant to give patients food parcels and that he had hit a gardener with a stethoscope.

While Blaylock has been gagged from speaking to the media by the health department, Dr Ettiene Immelman, Manguzi’s medical manager, took the unusual step of issuing a statement responding to Nkonyeni’s allegations. He asked the health department to release his statement but so far it has refused to do so.

Radiographer Mdunge had ‘numerous written warnings’ for being drunk on duty, according to the statement.

‘On the night in question he was unavailable for hours. When he eventually arrived he was too drunk to perform his duties and was very aggressive,’ said Immelman.

‘There was an altercation (with Blaylock) where he fell and cut himself. The radiographer laid a charge, the matter went to court, but was dismissed and the radiographer got a lecture about drinking on duty by the judge.’

Playing on the racial stereotype that white people care more about their pets than about black people, Nkonyeni claimed in media interviews that Blaylock had treated a dog in a bed meant for patients and allowed his own dogs to sit in on operations.

However, the curious incident of the dog in the operating theatre never happened, according to Immelman.

Instead, four years ago at 7.30am on a Saturday morning in the outpatients department (OPD), when no patients were waiting, Blaylock ‘put a chest drain in the dog owned by a member of the community and not his own’, said Immelman.

At the time, the hospital had a policy of treating pets as there are no veterinary services in Manguzi. However, this was not supposed to take place in OPD.

‘There was a complaint. The hospital outcome was ‘counselling as a discipline’,’ added Immelman. ‘Professor Green Thompson, the then Director General of KwaZulu-Natal Health, referred a complaint to the Health Professions Council of SA where Blaylock was cleared. The HPCSA made a ruling that doctors are allowed to use there medical skills for animals in the event of no skills in the vicinity.’

In the pharmacy incident, Blaylock lost his temper with the pharmacist who had failed to order anaesthetic drugs.

‘There were no anaesthetic drugs in the pharmacy. Blaylock had a patient on the operating table requiring emergency abdominal surgery, who later died,’ said Immelman. ‘He smashed the window, and got a written warning. The pharmacy staff consequently were also disciplined regarding stock control.’

Blaylock denies calling strikers baboons during an altercation with strikers who had blocked a busload of patients from entering the hospital grounds, and security staff at the gate did not hear such remarks either, added Immelman.

There was no incident with a gardener being hit by a stethoscope.

As the hospital has only been allocated 1 500 food parcels and these would run out within a few months, the hospital management, not Blaylock, decided that they should be allocated strictly according to people with a body-mass index of less than 20 ‘ something that was conveyed to Nkonyeni when she visited the hospital in February. However, she persisted this week in claiming that Blaylock in particular was guilty of withholding food from patients.

Nkonyeni told reporters this week that while she did not have a vendetta against Manguzi, ‘the person of Peggy Nkonyeni was personally attacked’ when Blaylock threw her picture in the dustbin in February.

During his disciplinary hearing, Blaylock apologized for this ‘irrational action’, saying that he was provoked by Nkonyeni’s remark that rural doctors were motivated by profit not by caring for people.

The SAHCS and Rudasa, which represent about 13 000 healthworkers, said this week that Nkonyeni had ‘abused her authority and undermined the dignity of her office’.

They described Nkonyeni’s task team ‘ the composition of which has yet to be announced ‘ as ‘an aggressive and prejudged ‘investigation’ of alleged transgressions ‘ which have already been investigated and of which Dr Blaylock has been cleared’.

‘Framing his and others’ actions as racist, when no investigation has been

done by the MEC, is inflammatory, irresponsible, and divisive,’ said the organisations. stressing that ‘the loss of doctors in rural areas is measured in lives lost’.

The organisations have once again asked to meet the MEC, the national ANC leadership and for an assurance that ‘rural doctors in KZN and in particular at Manguzi Hospital will not be victimised’.

Meanwhile, Blaylock set off for Carletonville this weekend to start a month-long locum at a mine hospital after the health department failed to inform him in writing that his month-long suspension without pay had been lifted, as announced by Nkonyeni on Tuesday.

Allegations against Blaylock

Nkonyeni: 1. ‘Allegation of illegal usage of theatre facilities to operate a dog, while patients wait in line to be attended to. Mind you, none of our hospitals offer veterinary services and we are not about to allow any animals to be operated in theatres meant for our people’.

Dr Ettiene Immelman, Manguzi Medical Manager: ‘There was such an incident four years ago. It took place at 7.30am on a Saturday morning when there were no “lines of patients” and also not in operating theatre, but in the resuscitation unit in outpatients department (OPD). Blaylock put a chest drain on the dog owned by a member of the community and not his own. There was a complaint. The hospital outcome was “counselling as a discipline”. Prof. Green Thompson, the then Director General of KZN Health referred a complaint to the Health Professions Council of SA (HPCSA) where Blaylock was cleared. HPCSA made a ruling that Doctors are allowed to use there medical skills for animals in the event of no skills in the vicinity.’

The hospital at that time had a policy in place which allowed for treatment of animals but not in OPD, hence the charge.

2. ‘Allegation of assault to the Radiographer, Mr. Clifford Mdunge, who had to be stitched after this severe assault’.

‘The radiographer was often drunk on duty and doctors and nurses had complained about him. On the night in question he was for hours unavailable. When he eventually arrived he was too drunk to perform his duties and was very aggressive. There was an altercation where he fell and cut himself.

The radiographer laid a charge, the matter went to court, but was dismissed and the radiographer got a lecture about drinking on duty by the judge. The radiographer in question also received numerous written warnings from the institution regarding being drunk on duty.’

3. ‘Allegation of damaging pharmacy window after he wanted to assault staff in the pharmacy and he himself had to be treated at the operating theatre as a result,’

‘There was such an incident. There were no anaesthetic drugs in the pharmacy and Blaylock had a patient on the operating table requiring emergency abdominal surgery (who later died). He smashed the window, and got a written warning. The pharmacy staff consequently were also disciplined regarding stock control.’

4. ‘Ill treatment and name calling of staff during last year public sector strike period, whereupon he referred to them as ‘baboons’, and in this instance again, he apologized.’

‘There was an altercation with strikers who were preventing a bus carrying patients from entering the hospital. Blaylock denied categorically that he used the word “baboons” or “monkeys” and a meeting took place with COSATU afterwards, where this was repeated.

Security staff on duty at the gate at that time also confirmed that they did not hear those words. A lot of intimidation took place at that time and racist remarks were made by protestors, for example ‘drain the apartheid blood’ and all staff that continued to work was referred to as rats.’

5. ‘Allegation of receiving donations in a manner that does not conform to the PFMA and Treasury Regulations which were to be used for research purposes.’

Immelman did not respond to this but it is understood that the MEC is referring to donor funds raised by Dr Colin Pfaff to purchase antiretroviral medication to prevent HIV positive mothers from passing the virus on to their babies. This was done through a church trust and not the hospital, with the full knowledge of the hospital manager.

6. ‘Allegation of research projects where informed consent issues are not fully canvassed with patients.’

‘Regarding unethical research: Manguzi does not do any clinical research.’

7. ‘Allegation of implementing international policies of which are not aligned to both our government and departmental policies.’